Pharmaceutical compositions comprising an antibody which binds the human anti-mullerian hormone receptor type II

ABSTRACT

The invention relates to novel pharmaceutical compositions including, as active ingredient, an antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II) and an anticancer agent, as well as the therapeutic applications of these compositions.

The present invention relates to novel pharmaceutical compositions comprising, as active ingredient, an antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II), as well as the therapeutic uses of these compositions.

The human anti-Müllerian hormone is a glycoprotein of 560 amino acids, a member of the TGF-β family. It is a hormone secreted by the Sertoli cells of the fetal testis, which causes degeneration of the Müllerian duct. It is expressed in the adult in the Sertoli cells and Leydig cells (testis) and the granulosa cells (ovary). It plays a role in the activity of the adult ovary in the regulation of folliculogenesis.

The anti-Müllerian hormone type II receptor (AMHR-II) is a peptide of 573 amino acids and possesses serine-threonine kinase activity. It is involved in the regression of the Müllerian duct associated with the development of the human reproductive system. The Müllerian duct atrophies in men, where it only forms the prostatic vesicle and the sessile hydatid, but persists in women, where it gives rise to the Fallopian tubes, uterus and the greater part of the vagina. This receptor is frequently expressed on human ovarian epithelial tumour cells.

International application WO 2008/053330 describes a murine 12G4 monoclonal antibody directed against AMHR-II for treating ovarian cancers.

International application WO 2011/141653 describes mutated humanized 12G4 antibodies, or fragments thereof, possessing an affinity at least equal to that of the corresponding unmutated chimeric antibody, specificity with respect to the AMHR-II receptor, and not eliciting an immune reaction.

The purpose of the present invention is to propose a therapeutic alternative that is advantageous for patients with a pathology connected with the human anti-Müllerian hormone type II receptor (AMHR-II).

A pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II) may in particular be: ovarian cancer, in particular metastatic ovarian cancer, serous cancer, hypernephroma, endometrioid, colloidal epithelium, it may also be: prostate cancer, germ cell cancer, endometrial cancer, mixed Müllerian malignant tumour of the uterus, leiomyosarcoma, and endometrial stromal sarcoma.

Ovarian cancer is the main cause of gynaecological cancers and is the fifth commonest cause of mortality from cancer in woman. It has the following three histological origins:

-   -   the surface epithelium (epithelial tumour with various         subtypes), which represents 85-90% of ovarian cancers,     -   sexual cords/stroma (granulosa tumour (3% of total ovarian         cancers)), which represent about 10% of ovarian tumours,     -   germ cells, which represent 5% of ovarian cancers.

It is generally asymptomatic during the initial stages, hence its nickname “silent killer” (La Marca A., Volpe A. The Anti-Mullerian hormone and ovarian cancer. Human Reproduction Update, Vol. 13, No. 3 pp. 265-273, 2007).

There are four stages and prognoses (FIGO classification: International Federation of Gynaecology and Obstetrics) for which the survival rate decreases considerably from stage 2:

Stage I: Tumour limited to the ovaries (5-year survival: 90-70%),

Stage II: Tumour in one or two ovaries and extends to pelvis (5-year survival: 70-40%),

Stage III: Tumour in one or two ovaries, extending outside the pelvis (5-year survival: 20%),

Stage IV: Distant metastases excluding peritoneal metastases (5-year survival: <10%),

(Fauci, Braunwald et al. Principles of internal medicine. Harrison's 17th edition/National Cancer Institute cancer.gov/CNGOF (French National Colleges of Gynaecologists and Obstetricians).

Regarding ovarian cancer, the main strategies used for treatment are surgery and chemotherapy, in particular as first-line treatment, such as a mixture of carboplatin and paclitaxel.

Monoclonal antibodies have also recently been developed such as cetuximab, which is directed against the epidermal growth factor receptor (EGFR, Ozols R. F. et al., Focus on epithelial ovarian cancer, Cancer Cell. 2004, January; 5(1): 19-24). Other monoclonal antibodies are currently in phase III, such as abagovomab directed against CA-125, avastin directed against vascular endothelial growth factor (VEGF-A), or farletuzumab directed against folate receptor alpha (FRA).

The purpose of the present invention is to propose a therapy directed against a target different from the antibody targets currently developed. The invention offers the advantage of proposing a treatment against various pathologies associated with AMHR-II. Moreover, in the case of ovarian cancer, the invention offers the possibility of a therapy that is more effective than the reference therapy for reducing tumour volume, thus allowing a quicker improvement in the patient's condition.

This purpose is achieved by means of a composition according to the invention.

The present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle,

-   -   an anticancer agent, and         an antibody binding the human anti-Müllerian hormone type II         receptor (AMHR-II).

In the invention, the term “antibody” refers to an immunoglobulin, a multimeric protein consisting of 4 chains, i.e. 2 light chains and 2 heavy chains, each comprising a variable region and a constant region. More precisely, each light chain consists of a variable region (V_(L)) and a constant region (C_(L)). Each heavy chain consists of a variable region (V_(H)) and a constant region consisting of three constant domains C_(H1), C_(H2) and C_(H3). The domains C_(H2) and C_(H3) make up the domain Fc. The variable region of the light chain consists of three regions determining recognition of the antigen (complementarity determining region, CDR) surrounded by four framework domains. The three-dimensional folding of the variable region is such that the 3 CDRs are exposed on the same side of the protein and allow formation of a specific structure recognizing a defined antigen.

An “anticancer agent” is defined as any molecule that can either interfere with the biosynthesis of macromolecules (DNA, RNA, proteins, etc.) or inhibit cellular proliferation, or lead to cell death by apoptosis or cytotoxicity for example. Among the anticancer agents, there may be mentioned alkylating agents, topoisomerase inhibitors and intercalating agents, anti-metabolites, cleaving agents, agents interfering with tubulin, monoclonal antibodies.

A “pharmaceutically acceptable vehicle” refers to a non-toxic material that is compatible with a biological system such as a cell, a cell culture, a tissue or an organism.

According to a particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent and an antibody binding AMHR-II, in which said antibody binding AMHR-II is a polyclonal antibody.

The term “polyclonal antibody” denotes a mixture of antibodies, capable of recognizing various antigenic determinants of a target protein.

According to another particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which said antibody is a monoclonal antibody, and preferably a chimeric or humanized 12G4 monoclonal antibody.

A “monoclonal antibody” is defined as an antibody that only recognizes a single antigenic determinant of the target protein.

By “chimeric monoclonal antibody” is meant an antibody in which the variable regions of the light chains and heavy chains belong to a species different from that of the constant regions of the light chains and heavy chains. By extension or usage a chimeric antibody refers to an antibody with constant portions of human origin.

The chimeric antibodies according to the invention may be prepared using the techniques of genetic recombination. For example, a chimeric antibody may be produced by constructing a chimeric gene comprising a nucleotide sequence of complementary DNA (cDNA) or a genomic sequence with introns coding for the variable region of the heavy chain of a murine monoclonal antibody, joined to a nucleotide sequence coding for the constant region of the heavy chain of a human antibody, and by constructing a chimeric gene comprising a nucleotide sequence coding for the variable region of the light chain of a murine monoclonal antibody, joined to a nucleotide sequence coding for the constant region of the light chain of a human antibody. By transfecting said chimeric genes, by protoplast fusion or any other technique, into a cell line, of murine myeloma for example, production of mouse-human chimeric antibodies by the transformed cells is obtained. It is the document Morrison et al., Proc. Natl. Acad. Sci. U.S.A., 81, pp. 6851-55 (1984) that described the preparation of such antibodies for the first time. The documents Boulianne, G. L. et al., Nature, 312: 643-646 (1984), Sun, L. K., et al., Proc. Natl. Acad. Sci. USA (1984), 214-218, U.S. Pat. Nos. 4,816,567, 6,331,415, 6,808,901 and EP 125023 could also be used as reference by a person skilled in the art, as well as Bobrzecka, K., et al., Immunology Letters 2, pp 151-155, which describes a procedure of splitting of the interchain disulphide bridges of the immunoglobulins followed by ordered rearrangement of these same disulphide bridges in order to obtain antibodies formed from rabbit Fab fragments and human Fc fragments.

Another possible approach for the preparation of chimeric antibodies, as described in document FR 2 641 468, is to graft Fab′ fragments of a murine monoclonal antibody onto human polyclonal immunoglobulins, in particular IgG, or onto Fc fragments, using a coupling agent, for example a diimide. Chimeric antibodies of the type Ig-Fab′ (also designated Fab′-Ig), Fc-Fab′ or (Fab′)2 may thus be obtained. Such chimeric antibodies are characterized by grafting the whole of the Fab′ fragment, and not only the variable portions.

Alternatively, other authors have described the production of monovalent chimeric antibodies by grafting Fab′ fragments of polyclonal antibodies onto IgG or onto Fc fragments (G. T. Stevenson et al., Med. Oncol. & Tumor, 1985, Pharmacother., Vol. 1, No. 4, 275-278, 1984).

Homologous recombination in vivo between the portions of the genes coding for the constant regions of the light chains and heavy chains of a murine immunoglobulin by portions of the genes coding for the constant regions of the light chains and heavy chains of a human immunoglobulin is also a means that may be used in order to obtain such antibodies (U.S. Pat. Nos. 5,204,244 or 5,202,238). This is not an exhaustive list.

By “humanized monoclonal antibody” is meant an antibody in which some or all of the sequences of the regions involved in antigen recognition (the hypervariable regions (CDR: Complementarity Determining Region), and sometimes certain amino acids of the FR regions (Framework regions)), are of non-human origin (preferably murine) whereas the sequences of the constant regions and variable regions not involved in antigen recognition are of human origin.

The humanized antibodies according to the invention may be prepared by well-known techniques, such as that described for the first time in the document by Jones et al., Nature, 1986, 321-522-525. This involved replacing the hypervariable regions (CDRs) of a human antibody with hypervariable regions of murine origin, both at the level of the light chains but also of the heavy chains. This technique, now well known to a person skilled in the art under the name “CDR grafting”, is described in numerous documents such as Singer et al., J. Immun. 150: 2844-2857 (1993), Riechman et al., Nature, Vol. 332, 323: 326 (1988), or in U.S. Pat. Nos. 5,225,539; 5,585,089; EP 0682040, which may also be used as reference.

However, most of the humanized antibodies produced by grafting of the CDR regions have reduced affinity relative to a murine antibody, owing to the major role of certain amino acids of the framework regions in the spatial positioning of the non-human amino acids including the CDRs as well as in the binding to the antigen. That is why today a person skilled in the art quite often replaces, in the human receiving Ig, not only the CDRs, but also the residues of the framework regions that may contribute to the binding site of the antigen.

Another technique for humanizing antibodies is the technique of grafting the specific determining residues (Specificity Determining Region, SDR), which consists of no longer grafting the whole of the CDR regions, but only the SDR regions of the non-human antibody in the human variable regions (Tamura et al., J Immunol. 2000; 164: 1432-41). The SDR regions are defined as the regions of the CDRs in direct contact with the antigen (Padlan et al. (1995), FASEB J. 9: 133-139). This technique therefore requires identification of the SDRs. This may be done, for example, by determining the 3D structure of the antigen-antibody complex, using the database of the SDRs already identified (http://paradox.harvard.edu/sdr), or else by comparing the human variable sequences with those of the non-human species, using computer software such as DomainGapAlign, CLUSTALW2, CLUSTALX, BLAST or FASTA.

Another alternative for obtaining humanized antibodies consists of grafting regions called “abbreviated CDRs” (“grafting of abbreviated CDRs”). It involves grafting the SDR regions and some adjacent residues, upstream and downstream of the sequence. The documents by De Pascalis et al., The Journal of Immunology, 2002, 169: 3076-3084; Kashmiri Syed V. S et al., Methods, Volume 36, Issue, May 2005, Pages 25-34 will be able to be used as reference.

The composite humanization technology developed by Antitope (WO 2006082406) is a CDR grafting technique that considers the framework regions independently and aims to select the human equivalents separately in such a way that the presentation of the residues interacting with the antigen are better conserved in their orientation.

The so-called resurfacing technique, “variable domain resurfacing”, also called “veneering”, as developed by ImmunoGen (U.S. Pat. No. 5,639,641) or Xoma (EP 0571613, U.S. Pat. Nos. 5,766,886, 5,770,196, 5,821,123, 5,869,619) may also be used. This technology consists of giving a human “profile” to a mouse variable domain by replacing the residues exposed on the surface in the framework regions of the murine antibodies with the residues usually found on the surface of the human antibodies. The documents by Roguska et al., Proc Natl Acad Sci USA 1994; Mark G. E. et al. (1994) in Handbook of Experimental Pharmacology Vol. 113: The pharmacology of monoclonal Antibodies, Springer-Verlag, pp 105-134 may also serve as reference.

The Germliner™ platform developed by AvantGen may also be used (http://www.avantgen.com/AvantGensTechnologiesandServices.pdf). This makes it possible to obtain humanized antibodies in which only CDR3s are of non-human origin.

This is not an exhaustive list. Obtaining said humanized antibodies will, moreover, preferably be coupled to an affinity maturation process.

The production of the humanized 12G4 monoclonal antibody is described in detail in international application WO 2011/141653. The antibodies described in the invention are isolated and purified. These antibodies are mature, i.e. they possess an ad hoc three-dimensional structure allowing them to recognize the antigen, and possess all the post-translational modifications essential to their antigenic recognition, in particular glycosylation and the formation of intramolecular and intermolecular disulphide bridges.

According to another aspect, the invention relates to a fragment of a mutated humanized 12G4 monoclonal antibody as defined above, selected from the group of fragments consisting of: Fc, Fab′-SH, Fd, Fv, Fab, F(ab′)2, Fab′, dsFv, scFv, Sc(Fv)2, diabody, triabody or tetrabody or also nanobody.

According to an even more particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which the chimeric or humanized 12G4 monoclonal antibody is mutated, and comprises at least one mutation in the light and/or heavy chain.

According to an even more particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which the chimeric or humanized 12G4 monoclonal antibody is mutated, comprises at least one mutation in the light and/or heavy chain, and has an affinity for AMHR-II characterized by a K_(D) preferably less than 10⁻⁷ M, in particular less than 10⁻⁸M, in particular in the range from 10⁻⁹M to 10⁻¹¹ M.

More particularly, the present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and a monoclonal antibody binding AMHR-II, in which said monoclonal antibody is a humanized 12G4 antibody, or a fragment of humanized 12G4 monoclonal antibody, said humanized 12G4 monoclonal antibody being mutated, and comprises at least one mutation in the light and/or heavy chain, said mutated antibody possessing an affinity for the human anti-Müllerian hormone type II receptor (AMHRII) characterized by a K_(D) preferably less than 10⁻⁷ M, in particular less than 10⁻⁸ M, in particular in the range from 10⁻⁹ M to 10⁻¹¹ M.

By “mutated humanized 12G4 monoclonal antibody” is meant a humanized 12G4 monoclonal antibody in which at least one mutation was carried out in the variable region of the light chain and/or the constant region of the light chain and/or the variable region of the heavy chain or the constant region of the heavy chain. A mutated humanized 12G4 antibody, in a composition according to the invention, has an affinity at least equal to that of the corresponding unmutated chimeric antibody, a specificity with respect to AMHR-II and does not elicit an immune reaction.

Even more particularly, the present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and a monoclonal antibody binding AMHR-II, in which said mutated humanized monoclonal antibody comprises or is constituted by:

a) a light chain comprising or constituted by:

-   -   a variable region the amino acid sequence of which is         represented by SEQ ID NO: 1 or SEQ ID NO: 2, and     -   a constant region the amino acid sequence of which is         represented by SEQ ID NO: 3 or by a sequence having at least 80%         homology with SEQ ID NO: 3         b) a heavy chain comprising or constituted by:     -   a variable region the amino acid sequence of which is         represented by SEQ ID NO: 4, or SEQ ID NO: 5, and     -   a constant region the amino acid sequence of which is         represented by SEQ ID NO: 6 or by a sequence having at least 80%         homology with SEQ ID NO: 6,         in which the humanized 12G4 monoclonal antibody comprises at         least one mutation in the light and/or heavy chain, and has a         K_(D) for the human anti-Müllerian hormone type II receptor         (AMHR-II) preferably less than 10⁻⁷ M, in particular less than         10⁻⁸ M, in particular in the range from 10⁻⁹ M to 10⁻¹¹ M.         According to an even more particular aspect, the invention         relates to a pharmaceutical composition comprising, as active         ingredient, in combination with a pharmaceutically acceptable         vehicle, an anticancer agent, and an antibody binding AMHR-II,         in which the chimeric or humanized 12G4 monoclonal antibody is         mutated, and comprises at least one mutation in the light and/or         heavy chain. The references of the amino acid sequences of the         different portions of the antibodies are presented in the         following table:

Sequence references Sequence reference in in the application present invention WO 2011/141653 Humanized 12G4 antibody, SEQ ID NO: 1 SEQ ID NO: 2 light chain, variable region, without leader Humanized 12G4 antibody, SEQ ID NO: 2 SEQ ID NO: 4 light chain, variable region, with leader Humanized 12G4 antibody, SEQ ID NO: 3 SEQ ID NO: 6 light chain, constant region, Humanized 12G4 antibody, SEQ ID NO: 4 SEQ ID NO: 8 heavy chain, variable region, without leader Humanized 12G4 antibody, SEQ ID NO: 5 SEQ ID NO: 10 heavy chain, variable region, with leader Humanized 12G4 antibody, SEQ ID NO: 6 SEQ ID NO: 12 heavy chain, constant region 3C23K antibody, light chain, SEQ ID NO: 7 SEQ ID NO: 34 variable region, without leader 3C23K antibody, light chain, SEQ ID NO: 8 SEQ ID NO: 36 variable region, with leader 3C23K antibody, heavy chain, SEQ ID NO: 9 SEQ ID NO: 38 variable region, without leader 3C23K antibody, heavy chain, SEQ ID NO: 10 SEQ ID NO: 40 variable region, with leader 3C23K antibody, light chain, SEQ ID NO: 11 SEQ ID NO: 82 without leader 3C23K antibody, light chain, SEQ ID NO: 12 SEQ ID NO: 84 with leader 3C23K antibody, heavy chain, SEQ ID NO: 13 SEQ ID NO: 86 without leader 3C23K antibody, heavy chain, SEQ ID NO: 14 SEQ ID NO: 88 with leader

Even more particularly, the present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and a monoclonal antibody binding AMHR-II, in which said mutated humanized monoclonal antibody comprises or is constituted by:

a) a light chain comprising or constituted by:

-   -   a variable region the amino acid sequence of which is         represented by SEQ ID NO: 7 or SEQ ID NO: 8,     -   a constant region the amino acid sequence of which is         represented by SEQ ID NO: 3         b) a heavy chain comprising or constituted by:     -   a variable region the amino acid sequence of which is         represented by SEQ ID NO: 9 or SEQ ID NO: 10     -   a constant region the amino acid sequence of which is         represented by SEQ ID NO: 6

Even more particularly, the present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and a monoclonal antibody binding AMHR-II, in which said mutated humanized monoclonal antibody comprises or is constituted by:

-   a) a light chain constituted by the amino acid sequence represented     by SEQ ID NO: 11 (without leader) or SEQ ID NO: 12 (with leader),     and -   b) a heavy chain comprising or constituted by the amino acid     sequence represented by SEQ ID NO: 13 (without leader), or SEQ ID     NO: 14 (with leader).

Even more particularly, the present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and a monoclonal antibody binding AMHR-II, in which said mutated humanized monoclonal antibody is produced by the 3C23K clone.

The mutated humanized monoclonal antibody produced by the 3C23K clone is described in detail in international application WO 2011/141653. By reference to the humanized 12G4 monoclonal antibody, the 3C23K antibody has the mutations of the 3C_23 antibody, as well as an additional mutation, in the CDR of the variable region of the light chain (E184K) in which a glutamic acid is replaced with a lysine, i.e. replacement of an acidic amino acid with a basic amino acid consequently having a totally different charge since it is of opposite sign, yet still displays an activity but especially an affinity far better than that of the unmutated humanized 12G4 antibody, and greater than that of the unmutated chimeric 12G4 antibody, and does not cause an immune reaction.

The mutated humanized monoclonal antibody produced by the 3C23K clone displays fucosylation with a content of about 50%.

According to another aspect, the present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and a monoclonal antibody binding AMHR-II, in which said mutated humanized monoclonal antibody is produced by a clone described in application WO 2011/141653 and selected from the group consisting of: 3C_23, 6B_78, 4C_35 and 5B_42.

In a particular embodiment, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which said antibody is a recombinant antibody produced by animal transgenesis.

This recombinant antibody may thus be produced by any technique known to a person skilled in the art, for example by recombination in a host cell, transformed with one or more vector(s) that allow the expression and/or the secretion of the nucleotide sequences coding for the heavy chain and/or the light chain of the antibody. The vector generally comprises a promoter, translation start and stop signals, as well as appropriate regions for the regulation of transcription. It is maintained stably in the host cell and may optionally possess particular signals that specify the secretion of the translated protein. These different elements are selected and optimized by a person skilled in the art in relation to the cellular host used. Such vectors are prepared by methods commonly used by a person skilled in the art, and the resultant clones may be introduced into a suitable host by standard methods. The cellular host may be selected from prokaryotic or eukaryotic systems, for example bacterial cells but also yeast cells or animal cells, especially mammalian cells. The mammalian cells preferred for the production of the monoclonal antibodies are the YB2/0 rat line, the CHO hamster line, PER.C6™ (Crucell), 293, K562, NSO, SP2/0, BHK or COS. It is also possible to use insect cells. Another method of production is the expression of the recombinant antibody in transgenic organisms, for example in plants or especially in the milk of transgenic animals such as the rabbit, goat or pig. According to a preferred embodiment, the antibody is produced in the milk of non-human transgenic mammals, genetically modified to produce this glycoprotein. Preferably, it is milk of a transgenic rabbit or goat, preferably in the milk of a transgenic goat. Advantageously, the antibody produced by animal transgenesis, in particular in the mammary glands of a transgenic goat, has a glycosylation with a high degree of galactosylation, for example greater than 70%.

In particular, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which the anticancer agent is paclitaxel or a platinum salt selected from the group consisting of: oxaliplatin, cisplatin and carboplatin.

The anticancer agent may also be selected from chemotherapeutic agents other than the platinum salts, small molecules, monoclonal antibodies or else anti-angiogenesis peptibodies.

The chemotherapeutic agents other than the platinum salts include the intercalating agents (blocking of DNA replication and transcription), such as the anthracyclines (doxorubicin, pegylated liposomal doxorubicin), the topoisomerase inhibitors (camptothecin and derivatives: Karenitecin, topotecan, irinotecan), or else SJG-136, the inhibitors of histone deacetylase (vorinostat, belinostat, valproic acid), the alkylating agents (bendamustine, glufosfamide, temozolomide), the anti-mitotic plant alkaloids, such as the taxanes (docetaxel, paclitaxel), the vinca alkaloids (vinorelbine), the epothilones (ZK-Epothilone, ixabepilone), the anti-metabolites (gemcitabine, elacytarabine, capecitabine), the kinesin spindle protein (KSP) inhibitors (ispinesib), trabectedin or else ombrabulin (combretastatin A-4 derivative).

Among the small molecules there are the poly(ADP-ribose)polymerase (PARP) inhibitors: olaparib, iniparib, veliparib, rucaparib, CEP-9722, MK-4827, BMN-673, the kinase inhibitors, such as the tyrosine kinase inhibitors (TKI) among which there may be mentioned the anti-VEGFR molecules (sorafenib, sunitinib, cediranib, vandetanib, pazopanib, BIBF 1120, semaxanib, Cabozantinib, motesanib), the anti-HER2/EGFR molecules (erlotinib, gefitinib, lapatinib), the anti-PDGFR molecules (imatinib, BIBF 1120), the anti-FGFR molecules (BIBF 1120), the aurora kinase/tyrosine kinase inhibitors (ENMD-2076), the Src/Abl kinase inhibitor (Saracatinib), or also Perifosine, Temsirolimus (mTOR inhibitor), alvocidib (cyclin-dependent kinase inhibitor), Volasertib (inhibitor of PLK1 (polo-like kinase 1) protein, LY2606368 (inhibitor of checkpoint kinase 1 (chk 1), GDC-0449 (Hedgehog Pathway Inhibitor), Zibotentan (antagonist of the ETA-receptor), Bortezomib, Carfilzomib (proteasome inhibitor), cytokines such as IL-12, IL-18, IL-21, INF-alpha, INF-gamma.

Among the antibodies, there may be mentioned, the anti-VEGF: bevacizumab, the anti-VEGFR: ramucirumab, the anti-HER2/EGFRs: trastuzumab, pertuzumab, cetuximab, panitumumab, MGAH22, matuzumab, anti-PDGFR alpha: IMC-3G3, the anti-folate receptor: farletuzumab, the anti-CD27: CDX-1127, the anti-CD56: BB-10901, the anti-CD105: TRC105, the anti-CD276: MGA271, the anti-AGS-8: AGS-8M4, the anti-DRS: TRA-8, the anti-HB-EGF: KHK2866, the anti-mesothelins: amatuximab, BAY 94-9343 (immunotoxin), catumaxomab (EpCAM/CD3 bispecific antibody), the anti-IL2R: daclizumab, the anti-IGF-1R: ganitumab, the anti-CTLA-4: ipilimumab, the anti-Lewis Y: Hu3S193, SGN-15 (immunotoxin), the anti-CAl25: oregovomab, the anti-HGF: rilotumumab, the anti-IL6: siltuximab, the anti-TR2: tigatuzumab, the anti-alpha5 beta1 integrin: volociximab, the anti-HB-EGF: KHK2866.

The anti-angiogenesis peptibodies are selected from AMG 386 and CVX-241.

More particularly, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which the anticancer agent is carboplatin.

Even more particularly, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which the mutated humanized monoclonal antibody is produced by the 3C23K clone and the anticancer agent is carboplatin.

In a particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which the anticancer agent is paclitaxel.

In a more particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in which the mutated humanized monoclonal antibody is produced by the 3C23K clone and the anticancer agent is paclitaxel.

In a particular aspect, the present invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent, and an antibody binding AMHR-II, in a formulation intended for administration by the intravenous or intraperitoneal route.

The pharmaceutical composition of the invention may be administered by any suitable administration route, for example by the parenteral, oral, sublingual, vaginal, rectal, or transdermal route, preferably by intravenous, subcutaneous or intradermal injection. Intramuscular, intraperitoneal, intrasynovial, intrathecal or intratumoral injection is also possible. The injections may be carried out in the form of a bolus, or by continuous infusion. When the antibody composition and the composition of anticancer agent are administered separately, these compositions may be in an identical or different form of administration.

The preparations for parenteral administration may include sterile aqueous or non-aqueous solutions, suspensions or emulsions. Examples of non-aqueous solvents are propylene glycol, polyethylene glycol, vegetable oils, such as olive oil, or injectable organic esters such as ethyl oleate. Aqueous vehicles comprise water, alcohol/water solutions, and emulsions or suspensions.

The pharmaceutical compositions according to the invention advantageously comprise one or more pharmaceutically acceptable excipients or vehicles. There may be mentioned for example saline, physiological, isotonic, buffered solutions, etc., compatible with pharmaceutical use and known to a person skilled in the art. The compositions may contain one or more agents or vehicles selected from dispersants, solubilizers, stabilizers, preservatives, etc. Agents or vehicles usable in formulations (liquid and/or injectable and/or solid) are in particular methylcellulose, hydroxymethylcellulose, carboxymethylcellulose, polysorbate 80, mannitol, gelatin, lactose, vegetable oils, acacia, etc. The compositions may be formulated in the form of injectable suspensions, gels, oils, tablets, suppositories, powders, hard gelatine capsules, soft capsules, etc.

According to a particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent and an antibody binding AMHR-II, in which the therapeutically effective quantity of antibody administered to a patient is in a range from about 0.07 mg to about 35000 mg, preferably from about 0.7 mg to about 7000 mg, preferably from about 0.7 mg to about 1400 mg, preferably from about 0.7 mg to about 700 mg, and more preferably from about 0.7 mg to about 70 mg.

The dosage of the active ingredient depends in particular on the administration method, and is easily determined by a person skilled in the art. A therapeutically effective quantity (unit dose) of antibody may vary from 0.01 mg/kg to 500 mg/kg, preferably from 0.1 mg/kg to 500 mg/kg, preferably from 0.1 mg/kg to 100 mg/kg, preferably from 0.1 mg/kg to 20 mg/kg, preferably from 0.1 mg/kg to 10 mg/kg, and more preferably from 1 mg/kg to 10 mg/kg, in one or more weekly administrations, for several weeks or months. The effective unit dose may therefore easily be deduced from a dose calculated for an “average” patient with a weight of 70 kg.

According to another particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent and an antibody binding AMHR-II, in which the therapeutically effective quantity of anticancer agent administered to a patient is in a range from about 10 mg to about 700 mg, preferably in a range from about 20 mg to about 350 mg, and preferably is about 110 mg.

The dosage of the anticancer agent depends in particular on the administration method, and is easily determined by a person skilled in the art. A therapeutically effective quantity (unit dose) may vary from 0.2 mg/m² to 10 g/m², preferably from 0.2 mg/m² to 1 g/m², preferably from 2 mg/m² to 1 g/m², preferably from 20 mg/m² to 1 g/m², and more preferably from 20 mg/m² to 0.5 g/m², in one or more weekly administrations, for several weeks or months. The effective unit dose may therefore be deduced from a dose calculated for an “average” patient whose body surface area is about 1.8 m².

According to an even more particular aspect, the invention relates to a pharmaceutical composition comprising, as active ingredient, in combination with a pharmaceutically acceptable vehicle, an anticancer agent and an antibody binding AMHR-II, in which the therapeutically effective quantity of anticancer agent administered to a patient is about 110 mg, and the therapeutically effective quantity of antibody administered to the patient is about 70 mg.

The invention also relates to a composition comprising an anticancer agent and an antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II), for use as a medicinal product in the prevention or treatment of a pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II).

By “treatment” is meant the means for treating a manifest pathology, the symptoms of which are visible. By “prevention” is meant the means for preventing said pathology from occurring.

A pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II) may in particular be:

-   -   ovarian cancer, in particular metastatic ovarian cancer, and its         various subtypes, in particular: serous, clear-cell,         endometrioid, mucinous,     -   germ cell cancer,     -   endometrial cancer,     -   mixed Müllerian malignant tumour of the uterus,     -   leiomyosarcoma,     -   endometrial stromal sarcoma,     -   prostate cancer,     -   testicular cancer.

Tumours expressing the AMHR-II antigen are targeted preferentially, i.e. tumours in which a significant level of expression of the AMHR-II antigen in a cell is observed, preferably on the surface of the cells.

According to the invention, the two therapeutic agents are used in combination in order to potentiate the antiproliferative effects of both of them.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which said antibody is a polyclonal antibody.

According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which said antibody is a monoclonal antibody, and preferably a chimeric or humanized 12G4 monoclonal antibody.

According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which said antibody is a mutated humanized 12G4 antibody, or a fragment of mutated humanized 12G4 monoclonal antibody, in which said monoclonal antibody comprises at least one mutation in the light and/or heavy chain.

According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which said antibody is a mutated humanized 12G4 antibody, or a fragment of mutated humanized 12G4 monoclonal antibody, in which said monoclonal antibody comprises at least one mutation in the light and/or heavy chain and has an AMHR-II affinity characterized by a K_(D) preferably less than 10⁻⁷ M, in particular less than 10⁻⁸ M, in particular in the range from 10⁻⁹ M to 10⁻¹¹ M. According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which said antibody is a mutated humanized 12G4 antibody, or a fragment of mutated humanized 12G4 monoclonal antibody, in which said monoclonal antibody comprises at least one mutation in the light and/or heavy chain.

According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which said 12G4 antibody comprises or is constituted by:

-   -   a) a light chain comprising or constituted by:         -   a variable region the amino acid sequence of which is             represented by SEQ ID NO: 1 or SEQ ID NO: 2, and         -   a constant region the amino acid sequence of which is             represented by SEQ ID NO: 3 or having at least 80% homology             with SEQ ID NO: 3,     -   b) a heavy chain comprising or constituted by:         -   a variable region the amino acid sequence of which is             represented by SEQ ID NO: 4, or SEQ ID NO: 5, and         -   a constant region the amino acid sequence of which is             represented by SEQ ID NO: 6 or by a sequence having at least             80% homology with SEQ ID NO: 6,             in which the humanized 12G4 monoclonal antibody is mutated,             comprises at least one mutation in the light and/or heavy             chain, and has a K_(D) for the human anti-Müllerian hormone             type II receptor (AMHR-II) preferably less than 10⁻⁷ M, in             particular less than 10⁻⁸ M, in particular in the range from             10⁻⁹ M to 10⁻¹¹ M.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the humanized monoclonal antibody comprises or is constituted by

-   -   a) a light chain comprising or constituted by:         -   a variable region the amino acid sequence of which is             represented by SEQ ID NO: 7 or SEQ ID NO: 8,         -   a constant region the amino acid sequence of which is             represented by SEQ ID NO: 3     -   b) a heavy chain comprising or constituted by:         -   a variable region the amino acid sequence of which is             represented by SEQ ID NO: 9 or SEQ ID NO: 10, and         -   a constant region the amino acid sequence of which is             represented by SEQ ID NO: 6.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the humanized 12G4 monoclonal antibody is produced by the clone 3C-23K.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the humanized 12G4 monoclonal antibody is a fragment of the humanized 12G4 monoclonal antibody produced by the clone 3C-23K.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the antibody is a recombinant antibody produced by animal transgenesis.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II) is cancer, and particularly ovarian cancer.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the anticancer agent is paclitaxel or a platinum salt selected from the group constituted by: oxaliplatin, cisplatin, carboplatin.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the anticancer agent is carboplatin.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the anticancer agent is paclitaxel.

In a particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising the 12G4 monoclonal antibody produced by the 3C23K clone and carboplatin.

In another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising the 12G4 monoclonal antibody produced by the 3C23K clone and paclitaxel.

In another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in a formulation intended for administration by the intravenous or intraperitoneal route.

In another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, the monoclonal antibody and the anticancer agent being intended for separate, simultaneous or sequential administration.

The antibody and the anticancer agent may be combined within one and the same pharmaceutical composition, or may be used in the form of separate pharmaceutical compositions, which may be administered simultaneously or sequentially. In particular, the products may be administered separately, namely either concomitantly, or independently, for example with a time gap.

More particularly, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the antibody and the anticancer agent are combined within the same pharmaceutical composition.

According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the therapeutically effective quantity of antibody administered to a patient is in a range from about 0.07 mg to about 35 000 mg, preferably from about 0.7 mg to about 7000 mg, preferably from about 0.7 mg to about 1400 mg, preferably from about 0.7 mg to about 700 mg, and more preferably from about 0.7 mg to about 70 mg.

According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the therapeutically effective quantity of anticancer agent administered to a patient is in a range from about 10 mg to about 700 mg, preferably in a range from about 20 mg to about 350 mg, and preferably about 110 mg.

According to another particular aspect, the invention relates to a composition for use as a medicinal product in the prevention or treatment of a pathology associated with AMHR-II, comprising an anticancer agent and an antibody binding AMHR-II, in which the therapeutically effective quantity of antibody administered to a patient is about 70 mg and the dose of anticancer agent administered to the patient is about 110 mg.

In a preferred embodiment, the dosage of anticancer agent, in particular carboplatin or paclitaxel, is in a range from about 0.01 mg/kg to about 500 mg/kg, for example 0.1 mg/kg to 300 mg/kg, or from about 0.1 mg to 20 g per day.

As a variant, a higher initial loading dose, followed by one or more lower doses may also be administered. In another variant, an initial loading dose that is not so high, followed by one or more higher doses may also be administered.

In a particular embodiment, the anti-AMHR-II antibody and carboplatin may be used in an antibody/carboplatin ratio in a range from about 10/1 to about 0.1/1, in particular from about 10/1 to about 1/1, or from about 1/1 to about 0.1/1.

In another particular embodiment, the anti-AMHR-II antibody and paclitaxel may be used in an antibody/paclitaxel ratio in a range from about 10/1 to about 0.1/1, in particular from about 10/1 to about 1/1, or from about 1/1 to about 0.1/1.

The invention further relates to a product comprising an antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II) and an anticancer agent, in the form of a combined preparation, for simultaneous, sequential or separate use as a medicinal product intended for preventing or treating a pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II), in particular cancer, and more particularly ovarian cancer.

According to a particular aspect, the invention relates to a product comprising an antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II) and an anticancer agent, in the form of a combined preparation, for simultaneous, sequential or separate use as a medicinal product intended for preventing or treating a pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II), in particular cancer, and more particularly ovarian cancer, for simultaneous use of the antibody and of the anticancer agent.

According to another particular aspect, the invention relates to a product comprising an antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II) and an anticancer agent, in the form of a combined preparation, for simultaneous, sequential or separate use as a medicinal product intended for preventing or treating a pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II), in particular cancer, and more particularly ovarian cancer, for sequential use of the antibody and of the anticancer agent, in which the antibody is administered prior to the anticancer agent.

According to another particular aspect, the invention relates to a product comprising an antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II) and an anticancer agent, in the form of a combined preparation, for simultaneous, sequential or separate use as a medicinal product intended for preventing or treating a pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II), in particular cancer, and more particularly ovarian cancer, for sequential use of the antibody and of the anticancer agent, in which the anticancer agent is administered prior to the antibody.

The following figures, tables and examples illustrate the invention, without limiting its scope.

FIG. 1A shows the variation of the mean tumour volumes, expressed in mm³, on the y-axis, as a function of the number of days counting from the day of injection of the tumour cells. FIG. 1B shows the curve of the median tumour volumes in mm³, on the y-axis, as a function of the number of days counting from the day of injection of the tumour cells. In each of the graphs, the curve joining the filled squares represents the mean value of the mice in the control group, the continuous curve joining the diamonds represents the group of mice treated with the irrelevant antibody LFB-R565, the curve joining the filled triangles represents the group of mice treated with the 3C23K antibody, the continuous curve joining the filled circles represents the group of mice treated with carboplatin, the dotted curve joining the filled circles represents the group of mice treated with carboplatin and with the irrelevant antibody LFB-R565, the dotted curve joining the filled triangles represents the group of mice treated with carboplatin and with the 3C23K antibody.

FIGS. 2A to 2F show the curves of the individual tumour volumes, by groups. For each of the graphs 2A to 2F, the x-axis shows the number of days counting from the day of injection of the tumour cells, and the y-axis shows the tumour volume, each of the curves show the evolution of tumour volume for one animal. FIG. 2A shows the control group of mice, FIG. 2B shows the group of mice treated with the irrelevant antibody LFB-R565, FIG. 2C shows the group of mice treated with the 3C23K antibody, FIG. 2D shows the group of mice treated with carboplatin, FIG. 2E shows the group of mice treated with carboplatin and with the irrelevant antibody, FIG. 2F shows the group of mice treated with carboplatin and with the 3C23K antibody.

FIGS. 3A, 3B and 3C show the variation of the mean tumour volumes (3A) or the median tumour volumes (3B) and percentage survival, in 4 groups of mice treated respectively with the 3C23K antibody in monotherapy, paclitaxel in monotherapy or the combination of the 3C23K antibody and paclitaxel. A solution of NaCl was used as the control. FIG. 3A shows the variation of the mean the tumour volumes, expressed in mm³, on the y-axis, as a function of the number of days counting from the day of injection of the tumour cells. FIG. 3B shows the curve of the median tumour volumes in mm³, on the y-axis, as a function of the number of days counting from the day of injection of the tumour cells. FIG. 3C shows the respective percentage survival for the four groups, on the y-axis, as a function of the number of days counting from the day of injection of the tumour cells. In FIGS. 3A to 3C: the curves joining the diamonds correspond to the group treated with the control solution; the curves joining the squares correspond to the group treated with the 3C23K antibody in monotherapy; the curves joining the round dots correspond to the group treated with paclitaxel; the curves joining the triangles correspond to the group treated with the combination of the 3C23K antibody and paclitaxel.

FIGS. 4A, 4B, 4C and 4D show respectively the curve of the individual tumour volumes in 4 groups of mice treated respectively with the control solution (4A), the 3C23K antibody in monotherapy (4B), paclitaxel in monotherapy (4C), or the combination of the 3C23K antibody and paclitaxel (4D).

Table 1 gives a summary of the treatment schedule.

Table 2 gives a summary of the raw data for individual tumour volume.

Table 3 gives a summary of the raw data for mean tumour volume and standard deviation (SD).

Table 4 gives the raw data for the median tumour volumes and T/C ratio.

Table 5 gives a statistical analysis of the tumour volumes.

Table 6 gives a summary of the raw data for individual body weight.

Table 7 gives a summary of the raw data for mean body weight and standard deviation (SD).

Table 8 gives a summary of the raw data for individual body weight.

Table 9 gives a summary of the raw data for individual tumour volume.

Table 10 gives a summary of the raw data for the change in mean body weight.

Table 11 gives a summary of the raw data for the mean tumour volumes.

Table 12 gives a summary of the raw data for the median tumour volumes and for the T/C ratios.

Table 13 gives the results of statistical analysis.

Table 14 gives a summary of the raw data for the survival parameter

Table 15 gives the survival parameters

EXAMPLE Evaluation of the Activity of the Antibody Produced by the 3C23K Clone (3C23K Antibody), in Monotherapy or in Combination with Carboplatin, in a Model of Human Ovarian Cancer Cov434-AMHRII Asc1a5 in the Female Swiss Nude Mouse

1. Protocol

Female Swiss nude mice (Harlan Laboratories) were injected subcutaneously (s.c.) with 7.10⁶ cells of Cov434-AMHRII Asc1a5 (cell line of human ovarian cancer transfected with cDNA AMHRII) in Matrigel (1:1 ratio) under a volume of 150 μL on day 0 (D0).

The 3C23K antibody was evaluated according to the following scheme: 2 times per week for 6 weeks, for a total of 12 injections at about 10 mg/kg/injection, said administration regimen being designated below as “Q3-4D12”. Another group of mice was treated with an irrelevant antibody LFB-R565, administered at about 10 mg/kg/injection, according to the regimen Q3-4D12.

Carboplatin was evaluated, at a sub-optimum dose, i.e. about 60 mg/kg/injection, according to the following scheme: once a week, for 4 weeks, said administration regimen being designated below as “Q7D4”.

Carboplatin was also evaluated in combination with the 3C23K antibody or with the irrelevant antibody LFB-R565. Carboplatin was administered at about 60 mg/kg/injection according to the Q7D4 regimen and the 3C23K antibody or the irrelevant antibody LFB-R565 at about 10 mg/kg/injection according to the regimen Q3-4D12.

The mice were randomized on D11, when the volume of the tumours was between 50 and 158 mm³, and the treatments began on D13 (9 mice per group). The description of the treatment dates is presented in Table 1.

In the context of evaluating the activity of the combination of the 3C23K antibody and paclitaxel relative to that of the 3C23K antibody in monotherapy or of paclitaxel in monotherapy, the 3C23K antibody was injected according to the following regimen: once weekly for 4 weeks, for a total of 4 injections, at a dose of about 10 mg/kg/injection according to the Q7D4 regimen; paclitaxel was injected according to the following regimen: once weekly for 4 weeks, for a total of 4 injections, at a dose of about 15 mg/kg/injection (Q7D4 regimen).

The mice were randomized on D13, when the volume of the tumours was between 58 and 150 mm³, and the treatments began on D14 (8 mice per group).

a. Monitoring the Experiments in vivo

The tumours were usually measured twice weekly. Tumour volume (TV) was calculated using the following formula, in which the length corresponds to the largest of the tumour diameters, the width corresponds to the smallest of the tumour diameters and the tumour height: TV (mm³)=(length×width×height)/2.

The curves of the individual volume of the tumours were plotted.

In addition, for each group, curves of tumour growth were plotted using the calculated mean tumour volumes or the median tumour volumes.

The animals were sacrificed when the tumour volumes reached 2000 mm³ or for ethical reasons. The curves of mean values and median values as well as the statistical analyses were stopped when 20% of the mice in the group were dead.

In one experiment with 9 mice per group, the curves and analyses were therefore stopped when fewer than 8 values per group had been obtained (8 mice alive).

In one experiment with 8 mice per group, the curves and analyses were stopped when fewer than 7 values per group had been obtained (7 mice alive).

b. Evaluation of the Efficacy of the Treatment

Inhibition of tumour growth, defined as the ratio between the median tumour volumes of the treated mice relative to the treated control groups (T/C) was calculated as follows: T/C=(mean TV of the treated group/mean TV of the control group)×100 The National Cancer Institute used the following criteria for evaluating the anti-tumour activity of a product (Bissery et al., 1991):

-   -   T/C greater than 42%, the product is considered to be         ineffective     -   T/C between 42% and 10%, the product displays an anti-tumour         effect     -   T/C less than 10%, the product is really effective.

Moreover, to identify whether the treatment has a toxic effect, the weight of the mice was monitored individually once a week. The mean body weight of the mice was calculated for each group, until 20% of the mice in the group were dead.

c. Statistical Analyses

The statistical differences between the different groups were analysed by ANOVA comparison using the Statgraphics centurion XV software.

The ANOVA table breaks down the variance into two components: an inter-group component and an intra-group component. The ratio F is the ratio of the inter-group estimate to the intra-group estimate. When the P value of test F is greater than or equal to 0.05, there is no statistically significant difference between the mean values of the two groups, with a confidence level of 95%. P values less than 0.05 indicate a significant difference between the mean values of the two groups with a confidence level of 95%.

The raw data of the statistical analyses in experiments with the F ratio and P value are presented in the appendix for all the experiments.

A Kruskal-Wallis test was also carried out. When the P value is greater than or equal to 0.05, there is no statistically significant difference between the median of the two groups, with a confidence level of 95%. P values less than 0.05 indicate a significant difference between the medians of the two groups with a confidence level of 95%.

2. Results

2.1 Evaluation of Anti-Tumour Activity of the 3C23K Antibody in Combinations with Carboplatin

It appears that the 3C23K antibody or 3C23K displays significant anti-tumour activity compared to the control (NaCl solution) and to the LFB-R565 antibody (or LFB-R565) (FIGS. 1 and 2; Tables 2, 3, 4 and 5). Relative to the control, the 3C23K T/C ratios decreased from D14 to D36, on D18 the T/C ratio was 33% and was constantly less than 23% up to D36 (Table 4). Relative to the irrelevant antibody LFB-R565, the T/C ratios decreased from D14 to D36, on D18 the T/C ratio was 41% and was constantly less than 26% up to D36 (Table 4).

Moreover, the treatment with the irrelevant antibody LFB-R565 does not display anti-tumour activity relative to the control (FIGS. 1 and 2; Tables 2, 3, 4 and 5) since the T/C ratios were never less than 68% (Table 4).

Carboplatin also displays significant anti-tumour activity compared to the control or to the irrelevant antibody LFB-R565 (FIGS. 1 and 2; Tables 2, 3, 4 and 5). From D18 to D36, the T/C ratios relative to the control decreased gradually and the value was 40% on D36, indicating an anti-tumour activity (Table 4). Similarly, when compared to a group treated with the irrelevant antibody LFB-R565, the T/C ratio decreased from D25 to D36, reaching 35% on D36 (Table 4).

Results similar to those for the group treated with carboplatin were obtained with the combination carboplatin+LFB-R565, compared to the control group. From D18 to D36, the T/C ratios decreased gradually and, on D36, the T/C ratio was 40%, demonstrating an anti-tumour activity (Table 4).

When the group treated with carboplatin+LFB-R565 was regarded as the treated group and was compared to LFB-R565 alone, a decrease in the T/C ratios was observed starting from D22 and two T/C ratios less than 42% were found, on D25 and D36 (Table 4).

Moreover, there was no difference between the groups treated with carboplatin+LFB-R565 or with carboplatin alone (FIG. 1; Tables 2, 3, 4 and 5).

3C23K (10 mg/kg, Q3-4D12) and carboplatin (60 mg/kg, Q7D4) used in monotherapy showed an anti-tumour effect in this Cov434-AMHRII Asc1a5 xenografted tumour model at the doses tested (FIGS. 1 and 2; Tables 2, 3, 4 and 5).

Moreover, in the test conditions, 3C23K showed an anti-tumour effect greater than carboplatin. In fact, the T/C ratio of the group treated with 3C23K relative to the group treated with carboplatin decreased from D14 to D39, and from D22 to D39 the T/C ratios were less than 42%, which indicates an anti-tumour activity of 3C23K greater than that of carboplatin (Table 4).

When the group treated with carboplatin combined with 3C23K was compared to a control group, the combination showed a very strong anti-tumour effect: on D18 the T/C ratio was 24% and from D22 to D36 the T/C ratios were less than 10% (FIGS. 1 and 2; Tables 2, 3, 4 and 5).

Moreover, the combination of carboplatin (60 mg/kg, Q7D4) and 3C23K (10 mg/kg, Q3-4D12) showed an anti-tumour effect stronger than each of the components, 3C23K (10 mg/kg, Q3-4D12) or carboplatin (60 mg/kg, Q7D4) used in monotherapy (FIGS. 1 and 2; Tables 2, 3, 4 and 5).

In fact, when the group treated with carboplatin+3C23K was compared with the group treated with carboplatin, the combination showed a greater anti-tumour activity: on D14 the T/C ratio began to decrease and from D25 to D43 the calculated ratio was less than 11%.

Moreover, when the group treated with 3C23K and carboplatin was compared to the group treated with 3C23K, the combination showed an anti-tumour activity greater than that of the monotherapy with 3C23K. On D18, the T/C ratio began to decrease, and was found to be less than 42% between D22 and D29, which indicates an anti-tumour advantage, and was found to be less than 11% between D32 and D49, which indicates a large anti-tumour advantage (FIGS. 1 and 2; Tables 2, 3, 4 and 5).

Moreover, the group treated with carboplatin and 3C23K also showed an anti-tumour advantage compared to carboplatin combined with an irrelevant antibody LFB-R565 (Table 4).

The treatments had no effect until day 32 (Tables 6 and 7). On D32, a transient decrease in body weight was observed for the groups treated with carboplatin, carboplatin+LFB-R565 and carboplatin+3C23K. This decrease, after the third injection of carboplatin, on D28, was not greater than 15%, in comparison with the previous measurements on D25. The decrease was similar for the groups treated with carboplatin or carboplatin+LFB-R565 (about 15%) and was about 1% for the group treated with carboplatin+3C23K. In these three groups, the decrease in weight, slight and transient, was not regarded as a toxic effect as it was not confirmed after the 4th injection of carboplatin, on D34 (Tables 6 and 7).

3. Conclusions

In the present study the inventors evaluated the combination of 3C23K at 10 mg/kg, Q3-4D12, and the sub-optimum dose of carboplatin 60 mg/kg, Q7D4, on female nude mouse models with the Cov434-AMHRII Asc1a5 xenografted tumour, compared to a control group. An irrelevant antibody, LFB-R565 (10 mg/kg, Q3-4D12), was also tested, alone or in combination with carboplatin.

The results demonstrate that carboplatin (60 mg/kg Q7D4) exerts anti-tumour activity on Cov434-AMHRII Asc1a5. The results also demonstrate that 3C23K (10 mg/kg Q3-4D12) exerts anti-tumour activity on Cov434-AMHRII Asc1a5.

However, the anti-tumour activity observed with carboplatin alone was lower than that observed with 3C23K alone (10 mg/kg, Q3-4D12).

The combination of 3C23K and carboplatin was demonstrated as displaying an advantage when compared to 3C23K alone or to carboplatin alone and as a minimum had an additive effect.

Finally, the anti-tumour activity of 3C23K alone or in combination with carboplatin is specific, as no efficacy was observed with an irrelevant antibody, whether alone or in combination.

TABLE 1 Summary of the treatment schedule Treatment schedule Carboplatin control or Date Product vehicle LFB-R565 3C23K carboplatin carboplatin + LFB-R565 carboplatin + 3C23K 19-sep D11 Randomization of the animals 20-sep D12 21-sep D13 TT TT TT TT TT 22-sep D14 TT TT TT 23-sep D15 TT TT TT TT TT 24-sep D16 25-sep D17 26-sep D18 TT TT TT TT TT 27-sep D19 28-sep D20 29-sep D21 TT TT TT 30-sep D22 TT TT TT TT TT 01-oct D23 02-oct D24 03-oct D25 TT TT TT TT TT 04-oct D26 05-oct D27 06-oct D28 TT TT TT 07-oct D29 TT TT TT TT TT 08-oct D30 09-oct D31 10-oct D32 TT TT TT TT TT 11-oct D33 12-oct D34 13-oct D35 TT TT TT 14-oct D36 TT TT TT TT TT 15-oct D37 16-oct D38 17-oct D39 TT TT TT TT TT 18-oct D40 19-oct D41 20-oct D42 21-oct D43 TT TT TT TT TT 22-oct D44 23-oct D45 24-oct D46 TT TT TT TT TT 25-oct D47 26-oct D48 27-oct D49

TABLE 2 Summary of the raw data for individual tumour volume Individual tumour volume Sep. 19, Sep. 22, Sep. 26, Sep. 30, Oct. 3, Oct. 7, Oct. 10, Oct. 14, Oct. 17, Oct. 21, Oct. 24, Oct. 27, Mouse 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 Group number D11 D14 D18 D22 D25 D29 D32 D36 D39 D43 D46 D49 NaCl 1-SM 91 126 250 504 819 952 1020 2404 1-OD 72 169 143 297 303 1320 891 1260 1848 1564 2622 1-OG 96 147 216 520 700 588 2993 1-2O 107 180 240 468 480 644 864 1540 1560 2625 1-2OD 99 192 144 216 330 462 660 1144 2280 2-SM 60 163 248 252 336 504 1045 1617 2070 2-OD 74 120 135 392 441 936 1053 1589 2024 2-OG 158 234 324 672 495 819 1181 1607 1386 2178 2-2O 77 123 108 180 1264 420 490 630 828 912 1485 2080 LFB-R565 3-SM 90 203 173 378 432 792 1287 2321 3-OD 72 110 140 126 216 792 356 588 720 995 1215 1672 3-OG 96 154 297 360 465 840 1140 2166 2166 3-2O 153 175 460 324 520 588 690 1824 1790 2112 3-2OD 108 154 192 363 504 980 1536 2052 4-SM 58 176 216 270 385 585 1122 1980 2576 4-OD 72 110 140 197 410 693 616 774 528 624 413 630 4-OG 81 95 108 216 297 504 569 1584 1454 2079 4-2O 60 95 160 270 288 504 660 1144 1073 1672 1785 2321 3C23K 5-SM 98 104 72 60 0 0 0 0 0 0 0 0 5-OD 90 179 88 150 126 322 501 653 784 1171 1683 1870 5-OG 61 60 36 30 0 27 27 87 210 420 598 1188 5-2O 80 72 21 0 0 0 0 0 0 0 0 0 5-2OD 57 67 41 36 24 48 15 0 0 0 0 0 6-SM 147 216 140 131 180 225 275 363 315 631 504 784 6-OD 113 166 80 77 74 146 180 182 182 393 275 655 6-OG 72 84 72 158 216 385 644 784 1200 1403 1650 2646 6-2O 72 53 53 70 88 210 350 432 546 731 518 945 carboplatin 7-SM 53 104 98 378 140 270 351 630 660 864 1071 1568 7-OD 142 210 173 126 240 200 243 424 484 592 501 819 7-OG 61 162 112 360 270 360 578 1148 1134 1881 2205 7-2O 102 210 336 324 616 768 864 1610 1495 2112 7-2OD 90 126 248 363 152 360 653 893 1488 2038 8-SM 72 123 140 270 358 363 504 462 447 882 810 1125 8-OD 81 75 90 156 98 168 220 308 347 438 378 480 8-OG 70 134 112 198 243 420 462 774 910 1105 1450 1650 8-2O 114 168 90 168 210 187 275 594 423 672 878 980 LFB-R565 + 9-SM 116 203 216 297 298 420 518 720 936 1323 1440 2112 carboplatin 9-OD 72 90 123 126 112 180 385 594 608 900 965 1233 9-OG 63 90 126 112 91 144 180 350 501 429 592 686 9-2O 102 150 180 220 170 330 336 726 564 675 570 936 9-2OD 98 168 299 420 432 1040 1134 2288 10-SM 51 210 193 210 264 410 455 704 774 1008 1378 1881 10-OD 130 180 338 280 193 865 798 1232 1449 1783 1320 2185 10-OG 68 72 85 135 123 192 266 462 840 1081 995 995 10-2O 81 90 98 108 117 210 248 216 378 293 3C23K + 11-SM 63 168 140 120 105 96 88 70 45 165 175 189 carboplatin 11-OD 123 102 54 38 24 40 18 0 24 66 69 90 11-OG 83 95 45 24 23 35 45 48 50 11-2O 83 96 53 24 18 81 18 18 0 18 23 24 11-2OD 123 112 112 24 0 0 0 18 0 18 34 81 12-SM 50 84 18 0 0 0 0 18 11 24 23 28 12-OD 72 77 47 72 54 108 88 140 100 242 250 325 12-OG 107 158 21 0 0 32 0 0 0 24 42 45 12-2O 65 60 72 98 132 112 105 160 184 357 273 539

TABLE 3 Summary of the raw data for mean tumour volume and standard deviation (SD) Mean tumour volume Day Group 11 14 18 22 25 29 32 36 39 43 46 49 Control Mean 93 161 201 389 463 738 1133 1474 SD 10 13 25 58 67 104 258 191 LFB-R565 Mean 10 14 38 31 37 58 140 222 SD 10 21 12 20 29 51 84 105 146 181 233 321 3C23K Mean 88 111 67 79 79 151 221 278 360 528 581 899 SD 10 21 12 20 29 51 84 105 146 181 233 321 carboplatin Mean 87 146 155 260 258 344 461 760 821 1176 SD 10 16 30 35 55 65 76 145 161 232 LFB-R565 + carboplatin Mean 87 139 184 212 200 421 480 810 756 936 SD 9 19 31 37 40 113 108 221 127 183 3C23K + carboplatin Mean 85 106 62 44 40 56 40 53 46 114 111 165 SD 9 12 13 14 16 15 14 20 21 46 38 65

TABLE 4 Raw data for median tumour volumes and T/C ratios Day 11 14 18 22 25 29 32 36 39 43 46 49 Mean tumour volume Control 91 163 216 392 441 644 1020 1564 LFB-R565 81 154 173 270 410 693 690 1824 3C23K 80 84 72 70 74 146 180 182 210 420 504 784 carboplatin 81 134 112 270 240 360 462 630 660 882 LFB-R565 + carboplatin 81 150 180 210 170 330 385 704 691 954 3C23K + carboplatin 83 96 53 24 23 40 18 18 24 45 55 86 TC ratio (%) Control-LFB-R565 89 95 80 69 93 108 68 117 Control-3C23K 88 52 33 18 17 23 18 12 Control-carboplatin 89 82 52 69 54 56 45 40 Control-LFB-R565 + carboplatin 89 92 83 54 39 51 38 45 Control-3C23K + carboplatin 91 59 24 6 5 6 2 1 LFB-R565-3C23K 99 55 41 26 18 21 26 10 LFB-R565-carboplatin 100 87 65 100 59 52 67 35 LFB-R565-LFB-R565 + carboplatin 100 97 104 78 42 48 56 39 LFB-R565-3C23K + carboplatin 102 63 30 9 5 6 3 1 carboplatin-3C23K 99 63 64 26 31 41 39 29 32 48 carboplatin-LFB-R565 + carboplatin 100 112 161 78 71 92 83 112 105 108 carboplatin-3C23K + carboplatin 102 72 47 9 9 11 4 3 4 5 3C23K-3C23K + carboplatin 103 115 73 34 31 27 10 10 11 11 11 11 LFB-R565 + carboplatin-3C23K + carboplatin 102 64 29 11 13 12 5 3 3 5

TABLE 5 Statistical analysis of the tumour volumes Statistical analysis of the tumour volumes Test Day Groups F ratio P value Sign. statistic P value Sign. D11 Control-LFB-R565 0.13 0.73 0.44 0.51 Control-3C23K 0.13 0.72 0.33 0.57 Control-carboplatin 0.16 0.69 0.28 0.60 Control-LFB-R565 + carboplatin 0.21 0.66 0.12 0.72 Control-3C23K + carboplatin 0.31 0.59 0.24 0.63 LFB-R565-3C23K 0.00 1.00 0.00 1.00 LFB-R565-carboplatin 0.00 0.97 0.00 0.96 LFB-R565-LFB-R565 + carboplatin 0.01 0.94 0.01 0.93 LFB-R565-3C23K + carboplatin 0.03 0.86 0.00 0.96 carboplatin-3C23K 0.00 0.97 0.00 0.96 carboplatin-LFB-R565 + carboplatin 0.00 0.97 0.00 1.00 carboplatin-3C23K + carboplatin 0.02 0.89 0.00 1.00 3C23K-LFB-R565 + carboplatin 0.01 0.94 0.01 0.93 3C23K-3C23K + carboplatin 0.03 0.86 0.00 0.96 LFB-R565 + carboplatin-3C23K + carboplatin 0.01 0.92 0.00 0.96 D14 Control-LFB-R565 1.23 0.28 1.22 0.27 Control-3C23K 4.54 0.05 * 3.60 0.06 Control-carboplatin 0.64 0.44 0.57 0.45 Control-LFB-R565 + carboplatin 1.03 0.32 0.63 0.43 Control-3C23K + carboplatin 10.41 0.01 * 7.74 0.01 * LFB-R565-3C23K 1.57 0.23 1.88 0.17 LFB-R565-carboplatin 0.05 0.83 0.10 0.76 LFB-R565-LFB-R565 + carboplatin 0.01 0.93 0.20 0.66 LFB-R565-3C23K + carboplatin 3.96 0.06 2.98 0.08 carboplatin-3C23K 1.88 0.19 2.00 0.16 carboplatin-LFB-R565 + carboplatin 0.08 0.79 0.13 0.72 carboplatin-3C23K + carboplatin 4.26 0.06 3.78 0.05 * 3C23K-LFB-R565 + carboplatin 1.08 0.31 1.76 0.18 3C23K-3C23K + carboplatin 0.05 0.82 0.10 0.76 LFB-R565 + carboplatin-3C23K + carboplatin 2.39 0.14 1.13 0.29 D18 Control-LFB-R565 0.04 0.84 0.05 0.83 Control-3C23K 25.29 0.00 * 11.57 0.00 * Control-carboplatin 1.51 0.24 2.26 0.13 Control-LFB-R565 + carboplatin 0.19 0.67 0.63 0.43 Control-3C23K + carboplatin 25.53 0.00 * 10.96 0.00 * LFB-R565-3C23K 14.01 0.00 * 11.62 0.00 * LFB-R565-carboplatin 1.39 0.26 2.27 0.13 LFB-R565-LFB-R565 + carboplatin 0.29 0.59 0.20 0.66 LFB-R565-3C23K + carboplatin 14.50 0.00 * 11.01 0.00 * carboplatin-3C23K 8.37 0.01 * 9.59 0.00 * carboplatin-LFB-R565 + carboplatin 0.50 0.49 0.78 0.38 carboplatin-3C23K + carboplatin 8.86 0.01 * 7.54 0.01 * 3C23K-LFB-R565 + carboplatin 13.69 0.00 * 9.84 0.00 * 3C23K-3C23K + carboplatin 0.07 0.80 0.20 0.66 LFB-R565 + carboplatin-3C23K + carboplatin 14.18 0.00 * 9.28 0.00 * D22 Control-LFB-R565 3.19 0.09 2.00 0.16 Control-3C23K 28.51 0.00 * 12.79 0.00 * Control-carboplatin 4.01 0.06 3.28 0.07 Control-LFB-R565 + carboplatin 7.35 0.02 * 5.28 0.02 * Control-3C23K + carboplatin 36.82 0.00 * 12.86 0.00 * LFB-R565-3C23K 33.73 0.00 * 10.98 0.00 * LFB-R565-carboplatin 0.17 0.69 0.13 0.72 LFB-R565-LFB-R565 + carboplatin 2.12 0.16 1.76 0.18 LFB-R565-3C23K + carboplatin 52.97 0.00 * 12.87 0.00 * carboplatin-3C23K 22.58 0.00 * 10.39 0.00 * carboplatin-LFB-R565 + carboplatin 0.99 0.33 1.12 0.29 carboplatin-3C23K + carboplatin 35.55 0.00 * 12.86 0.00 * 3C23K-LFB-R565 + carboplatin 11.13 0.00 * 6.79 0.01 * 3C23K-3C23K + carboplatin 2.19 0.16 2.14 0.14 LFB-R565 + carboplatin-3C23K + carboplatin 19.45 0.00 * 11.62 0.00 * D25 Control-LFB-R565 1.02 0.33 0.44 0.51 Control-3C23K 31.60 0.00 * 12.84 0.00 * Control-carboplatin 6.33 0.02 * 6.33 0.01 * Control-LFB-R565 + carboplatin 12.96 0.00 * 9.56 0.00 * Control-3C23K + carboplatin 42.71 0.00 * 12.84 0.00 * LFB-R565-3C23K 50.07 0.00 * 12.54 0.00 * LFB-R565-carboplatin 4.51 0.05 * 5.07 0.02 * LFB-R565-LFB-R565 + carboplatin 13.94 0.00 * 7.50 0.01 * LFB-R565-3C23K + carboplatin 83.99 0.00 * 12.84 0.00 * carboplatin-3C23K 9.51 0.01 * 8.27 0.00 * carboplatin-LFB-R565 + carboplatin 0.84 0.37 0.86 0.35 carboplatin-3C23K + carboplatin 16.39 0.00 * 11.61 0.00 * 3C23K-LFB-R565 + carboplatin 6.89 0.02 * 5.09 0.02 * 3C23K-3C23K + carboplatin 1.54 0.23 0.73 0.39 LFB-R565 + carboplatin-3C23K + carboplatin 15.49 0.00 * 9.87 0.00 * D29 Control-LFB-R565 0.13 0.72 0.00 1.00 Control-3C23K 28.90 0.00 * 12.80 0.00 * Control-carboplatin 11.64 0.00 * 9.57 0.00 * Control-LFB-R565 + carboplatin 4.78 0.04 * 5.28 0.02 * Control-3C23K + carboplatin 47.26 0.00 * 12.80 0.00 * LFB-R565-3C23K 56.20 0.00 * 12.83 0.00 * LFB-R565-carboplatin 18.53 0.00 * 9.86 0.00 * LFB-R565-LFB-R565 + carboplatin 5.30 0.04 * 4.31 0.04 * LFB-R565-3C23K + carboplatin 127.11 0.00 * 12.83 0.00 * carboplatin-3C23K 6.17 0.02 * 4.31 0.04 * carboplatin-LFB-R565 + carboplatin 0.39 0.54 0.03 0.86 carboplatin-3C23K + carboplatin 21.04 0.00 * 12.82 0.00 * 3C23K-LFB-R565 + carboplatin 5.32 0.03 * 4.13 0.04 * 3C23K-3C23K + carboplatin 3.64 0.07 1.44 0.23 LFB-R565 + carboplatin-3C23K + carboplatin 11.49 0.00 * 12.80 0.00 * D32 Control-LFB-R565 0.80 0.39 0.20 0.66 Control-3C23K 12.70 0.00 * 11.57 0.00 * Control-carboplatin 7.03 0.02 * 9.56 0.00 * Control-LFB-R565 + carboplatin 6.13 0.02 * 7.25 0.01 * Control-3C23K + carboplatin 20.13 0.00 * 12.87 0.00 * LFB-R565-3C23K 18.68 0.00 * 10.40 0.00 * LFB-R565-carboplatin 8.06 0.01 * 6.33 0.01 * LFB-R565-LFB-R565 + carboplatin 5.95 0.03 * 5.48 0.02 * LFB-R565-3C23K + carboplatin 40.84 0.00 * 12.87 0.00 * carboplatin-3C23K 5.03 0.04 * 4.13 0.04 * carboplatin-LFB-R565 + carboplatin 0.02 0.88 0.05 0.83 carboplatin-3C23K + carboplatin 33.41 0.00 * 12.87 0.00 * 3C23K-LFB-R565 + carboplatin 3.99 0.06 3.13 0.08 * 3C23K-3C23K + carboplatin 5.01 0.04 * 1.92 0.17 LFB-R565 + carboplatin-3C23K + carboplatin 18.20 0.00 * 12.87 0.00 * D36 Control-LFB-R565 0.22 0.65 0.28 0.60 Control-3C23K 36.45 0.00 * 10.76 0.00 * Control-carboplatin 10.34 0.01 * 6.03 0.01 * Control-LFB-R565 + carboplatin 5.70 0.03 * 5.33 0.02 * Control-3C23K + carboplatin 70.67 0.00 * 12.07 0.00 * LFB-R565-3C23K 32.80 0.00 * 11.01 0.00 * LFB-R565-carboplatin 11.39 0.00 * 6.12 0.01 * LFB-R565-LFB-R565 + carboplatin 7.22 0.02 * 5.07 0.02 * LFB-R565-3C23K + carboplatin 54.44 0.00 * 12.86 0.00 * carboplatin-3C23K 8.19 0.01 * 5.50 0.02 * carboplatin-LFB-R565 + carboplatin 0.04 0.84 0.02 0.89 carboplatin-3C23K + carboplatin 26.34 0.00 * 12.86 0.00 * 3C23K-LFB-R565 + carboplatin 5.33 0.03 * 5.09 0.02 * 3C23K-3C23K + carboplatin 4.99 0.04 * 1.68 0.19 LFB-R565 + carboplatin-3C23K + carboplatin 13.13 0.00 * 12.86 0.00 * D39 carboplatin-3C23K 5.05 0.04 * 4.70 0.03 * carboplatin-LFB-R565 + carboplatin 0.11 0.75 0.00 1.00 carboplatin-3C23K + carboplatin 25.47 0.00 * 12.84 0.00 * 3C23K-LFB-R565 + carboplatin 4.64 0.05 * 4.50 0.03 * 3C23K-3C23K + carboplatin 5.08 0.04 * 2.34 0.13 LFB-R565 + carboplatin-3C23K + carboplatin 39.24 0.00 * 12.06 0.00 * D43 carboplatin-3C23K 5.46 0.03 * 4.32 0.04 * carboplatin-LFB-R565 + carboplatin 0.72 0.41 0.33 0.56 carboplatin-3C23K + carboplatin 20.12 0.00 * 12.03 0.00 * 3C23K-LFB-R565 + carboplatin 2.85 0.11 2.38 0.12 LFB-R565 + carboplatin-3C23K + carboplatin 21.66 0.00 * 10.63 0.00 * 3C23K-3C23K + carboplatin 4.91 0.04 * 1.34 0.25 D46 3C23K-3C23K + carboplatin 3.95 0.07 1.34 0.25 D49 3C23K-3C23K + carboplatin 5.02 0.04 * 1.34 0.25

TABLE 6 Summary of the raw data for individual body weight Individual body weight of the mice Mouse Sep. 19, 2011 Sep. 26, 2011 Oct. 03, 2011 Oct. 10, 2011 Oct. 17, 2011 Oct. 24, 2011 Group number D11 D18 D25 D32 D39 D46 NaCl 1-SM 25.6 27.3 28.2 29.2 1-OD 22.3 24.8 24.7 25.0 27.0 28.9 1-OG 25.0 27.6 28.0 29.0 1-2O 21.5 22.8 23.2 24.6 25.8 1-2OD 25.0 27.0 28.1 29.6 29.6 2-SM 22.4 23.6 23.8 25.4 27.1 2-OD 24.0 26.1 26.8 29.3 30.0 2-OG 22.8 22.0 23.8 25.6 25.0 2-2O 24.4 24.4 25.2 27.0 27.1 29.6 LFB-R565 3-SM 23.4 23.3 24.0 25.1 3-OD 22.2 23.6 23.8 23.9 25.2 27.0 3-OG 23.5 24.4 24.8 25.8 3-2O 21.5 21.8 22.3 23.5 24.6 3-2OD 25.4 25.6 26.4 28.2 4-SM 23.6 25.0 25.1 26.6 28.2 4-OD 27.1 26.4 28.2 29.7 30.5 30.7 4-OG 23.2 24.1 24.6 26.3 26.8 4-2O 24.9 26.0 26.0 29.7 30.4 32.8 3C23K 5-SM 21.0 22.1 22.1 22.6 23.1 22.5 5-OD 20.2 21.8 22.2 23.5 24.1 24.9 5-OG 25.8 26.6 26.6 27.0 27.2 27.2 5-2O 24.9 25.2 25.0 25.2 27.8 26.0 5-2OD 23.5 26.4 26.0 26.0 26.5 27.2 6-SM 21.4 21.8 22.3 23.0 23.8 23.3 6-OD 23.0 24.2 25.0 24.0 26.0 25.7 6-OG 23.9 24.5 25.8 25.8 27.9 28.9 6-2O 24.9 24.0 24.3 24.8 25.3 25.8 carboplatin 7-SM 22.3 22.2 27.6 23.7 24.3 25.4 7-OD 25.8 24.6 28.3 24.5 23.9 25.7 7-OG 23.0 22.6 25.6 23.6 25.1 26.4 7-2O 27.1 26.1 32.7 28.0 27.2 7-2OD 23.3 24.4 27.0 23.1 25.4 8-SM 24.5 25.4 29.4 23.1 22.4 25.7 8-OD 22.7 23.6 25.6 21.1 20.0 21.7 8-OG 20.4 20.3 24.2 20.2 21.0 21.0 8-2O 22.3 22.0 26.0 23.6 23.3 25.0 LFB-R565 + 9-SM 22.2 21.8 26.2 20.9 22.7 23.1 carboplatin 9-OD 22.4 22.9 26.9 18.3 22.3 22.8 9-OG 24.0 23.9 27.7 23.0 23.8 24.8 9-2O 18.9 19.2 23.5 22.2 19.1 19.8 9-2OD 21.5 22.9 27.1 21.8 10-SM 23.0 22.6 23.9 22.7 25.3 24.3 10-OD 25.2 25.4 26.6 26.1 25.6 27.8 10-OG 25.8 25.3 28.2 27.0 26.2 27.5 10-2O 23.4 23.3 23.6 21.4 18.6 3C23K + 11-SM 26.8 26.8 26.3 27.0 26.9 27.5 carboplatin 11-OD 21.3 21.5 22.6 22.8 21.4 23.2 11-OG 20.0 19.2 20.1 18.8 17.0 11-2O 24.0 24.8 23.1 24.0 23.1 25.0 11-2OD 24.6 23.5 22.9 25.2 22.5 24.0 12-SM 21.8 23.7 24.0 22.5 21.0 22.5 12-OD 22.3 20.5 23.7 22.7 22.3 23.7 12-OG 22.7 24.2 24.4 23.1 21.6 22.8 12-2O 22.8 21.9 25.0 23.6 23.6 25.2

TABLE 7 Summary of the raw data for mean body weight and standard deviation (SD). Mean body weight of the mice Day Group 11 18 25 32 39 46 Control Mean 23.7 25.1 25.8 27.2 SD 1.5 2.0 2.0 2.1 LFB-R565 Mean 23.9 24.5 25.0 26.5 SD 1.7 1.5 1.7 2.3 3C23K Mean 23.2 24.1 24.4 24.7 25.7 25.7 SD 1.9 1.9 1.8 1.5 1.8 2.0 carboplatin Mean 23.5 23.5 27.4 23.4 23.6 SD 2.0 1.8 2.5 2.2 2.2 LFB-R565 + Mean 22.9 23.0 26.0 22.6 23.0 carboplatin SD 2.1 1.9 1.8 2.6 2.9 3C23K + carboplatin Mean 22.9 22.9 23.6 23.3 22.2 24.2 SD 2.0 2.3 1.7 2.2 2.6 1.6 2.2 Evaluation of an Anti-Tumour Activity of the 3C23K Antibody in Combination with Paclitaxel

The 3C23K antibody and paclitaxel are evaluated in vivo in monotherapy or in combination in the mice that received the injection of Cov434-AMHRII Asc1a5 tumour cells (a cell line of human ovarian cancer). The treatment is initiated on day 14 after injection.

It was observed that the 3C23K antibody administered at 10 mg/kg according to the Q7D4 regimen described above displays significant anti-tumour activity compared to a control solution (NaCl solution) (FIGS. 3 and 4; Tables 9, 11, 12, 13, 14 and 15).

Relative to the group treated with the control solution, the T/C ratios of the group treated with the 3C23K antibody decreased starting from D20. On D20 the T/C ratio was 57% and was constantly less than 29% up to D40 (Table 12).

Paclitaxel alone only shows a modest inhibition of tumour growth compared to the control solution. From D24 to D41, the T/C ratio changes from 83% to 53%.

Compared to the control, a greater anti-tumour activity was obtained in the group treated with the combination of the 3C23K antibody and paclitaxel (FIGS. 3 and 4; Tables 9, 11, 12, 13 14 and 15). The T/C ratio was less than 38% on D20 and was always less than 28% up to D41 (Table 12). Moreover, the T/C ratio on D31, D35 and D41 was 6%, 11% and 12% respectively. Compared to the result described by Bissery et al. in 1991, the results of the present invention show that the T/C ratio was around and less than 10% between D31 and D41, indicating that treatment with a combination of the 3C23K antibody and paclitaxel is an effective therapy.

Moreover, the 3C23K antibody administered at 10 mg/kg according to the Q7D4 regimen showed an anti-tumour effect greater than that of paclitaxel. In fact, the T/C ratio of the group treated with 3C23K relative to the group treated with paclitaxel decreased starting from D20. The T/C ratio on D20 was 47% and was less than 39% on D41 (Table 12), which indicates an anti-tumour activity of 3C23K greater than that of paclitaxel.

The combination of the 3C23K antibody (10 mg/kg, Q7D4) and paclitaxel (15 mg/kg, Q7D4 regimen) showed an anti-tumour effect stronger than each of the components, 3C23K (10 mg/kg, Q7D4) or paclitaxel (15 mg/kg, Q7D4 regimen) used in monotherapy.

In fact, when the group treated with the aforesaid combination was compared with the group treated with paclitaxel, the combination showed a greater anti-tumour activity: on D20 the T/C ratio began to decrease and the ratio was 31% on D20 and was less than 35% up to D41 (Table 12).

When the group treated with the aforesaid combination was compared with the group treated with the 3C23K antibody, the combination showed an anti-tumour activity greater than that of monotherapy with 3C23K. On D31, the T/C ratio began to decrease, the T/C ratio was 27% on D31 and was less than 42% up to D48 (Table 12). On D51, the T/C ratio is only 51%, nevertheless indicating a difference between these two groups, as 49% inhibition of tumour growth was observed (Table 12).

Statistical analysis of tumour volume confirms the results of analysis of the T/C ratio.

The 3C23K antibody in monotherapy and the 3C23K antibody in combination with paclitaxel show a significant anti-tumour activity compared to that of the control (NaCl solution) starting from D20 to D41 (Table 13).

Paclitaxel in monotherapy does not have an activity that is significantly different from that of the control (Table 13).

The 3C23K antibody in monotherapy displays an anti-tumour activity that is significantly different from that of paclitaxel in monotherapy starting from D20 to D41 (Table 13).

Compared to the paclitaxel treatment in monotherapy, treatment with the combination of the 3C23K antibody and paclitaxel displays a better anti-tumour activity starting from D20 to D41 (Table 13).

Statistical analysis based on the survival parameter also confirms the results for the T/C ratio and analysis of tumour volume.

The 3C23K antibody in monotherapy and the combination of the 3C23K antibody and paclitaxel respectively show a significant anti-tumour activity compared to that of the control (Table 15).

Paclitaxel in monotherapy does not have an activity that is significantly different from that of the control (Table 15).

The 3C23K antibody in monotherapy displays an anti-tumour activity that is significantly different from that of paclitaxel in monotherapy (Table 15). Compared to the paclitaxel treatment in monotherapy, treatment with the combination of the 3C23K antibody and paclitaxel displays a better anti-tumour activity (Table 15).

The treatments have no effect on body weight (Tables 8 and 10).

In conclusion, the combination of the 3C23K antibody and paclitaxel displays an advantage relative to 3C23K alone or to paclitaxel alone and as a minimum has an additive effect.

TABLE 8 Summary of the raw data for individual body weight Individual body weight Mouse Group number D20 D27 D35 D41 D48 D55 D62 D69 Control 1-SM 23.4 24.1 26.0 26.9 1-OD 23.6 25.4 26.5 1-OG 23.1 24.6 25.0 26.1 1-2O 21.8 23.4 25.2 25.4 1-2OG 23.7 25.8 26.8 27.8 1- 22.5 23.7 24.8 25.0 2OG/OD 10-2OD 22.1 23.4 24.3 23.5 24.7 26.1 10-2OG 22.4 23.5 28.4 27.8 28.5 29.6 3C23K 10 mg/kg 2-SM 21.3 21.8 23.0 22.4 23.3 24.6 q7d4 2-OD 25.0 24.8 26.8 27.0 27.5 2-OG 24.8 26.3 27.0 27.6 27.2 27.5 2-2O 23.7 25.0 25.4 27.0 25.4 25.5 26.6 26.6 2-2OD 25.5 26.3 26.7 27.0 26.8 26.9 27.6 27.7 2-2OG 27.1 26.9 28.7 29.2 28.7 28.0 28.2 28.6 8-SM 20.5 21.0 21.4 21.7 22.0 22.4 23.4 8-OD 25.3 26.1 26.0 26.5 27.6 27.4 28.9 28.7 Paclitaxel 15 mg/kg 6-SM 25.6 27.1 30.7 0.0 0.0 0.0 0.0 0.0 q7d4 6-OD 25.8 25.7 27.8 27.7 28.0 0.0 0.0 0.0 6-OG 24.5 24.3 26.2 26.5 0.0 0.0 0.0 0.0 6-2O 24.4 24.6 27.7 27.2 0.0 0.0 0.0 0.0 6-2OD 22.4 24.0 26.5 26.7 0.0 0.0 0.0 0.0 6-2OG 25.9 26.4 29.0 28.7 0.0 0.0 0.0 0.0 10-SM 24.8 25.0 26.8 27.1 26.8 0.0 0.0 0.0 10-OD 23.9 23.6 23.9 23.7 25.2 26.3 0.0 0.0 3C23K 10 mg/kg 7-SM 22.0 22.4 22.3 22.3 25.5 22.2 0.0 0.0 q7d4 7-OD 26.4 26.8 26.8 25.7 26.7 28.3 29.4 0.0 + 7-OG 24.1 25.1 25.9 25.6 26.3 26.2 0.0 0.0 Paclitaxel 15 mg/kg 7-2O 22.0 22.2 23.7 23.4 25.1 0.0 0.0 0.0 q7d4 7-2OD 22.4 22.6 24.3 26.0 24.4 25.8 26.6 0.0 7-2OG 22.5 23.6 25.0 25.0 24.9 26.7 27.6 0.0 10-OG 22.8 23.7 24.7 23.6 24.7 24.5 24.6 25.1 10-2O 22.7 23.7 24.4 23.8 24.7 25.0 25.4 26.8

TABLE 9 Summary of the raw data for individual tumour volume Day Group 13 20 24 27 31 35 41 45 48 51 Control 1-SM 150 403 495 910 840 1566 1966 2320 1-OD 98 423 660 1190 1568 2898 1-OG 96 189 399 561 1344 1734 2200 1-2O 90 210 297 423 520 770 1584 2058 1-2OG 74 187 358 576 1056 1276 2474 1- 65 162 315 469 725 1089 1396 2128 10-2OD 106 72 41 50 24 117 197 510 819 1008 10-2OG 66 105 81 126 143 366 631 725 1170 1521 3C23K 10 mg/kg q7d4 2-SM 144 105 158 252 184 366 560 918 912 1485 2-OD 98 135 180 289 404 592 844 1256 1672 2035 2-OG 98 88 0 0 0 0 0 0 0 0 2-2O 90 140 102 192 204 488 540 624 551 587 2-2OD 76 150 114 168 198 528 634 731 833 900 2-2OG 73 60 68 72 68 122 293 392 381 462 8-SM 88 105 84 90 140 268 394 529 689 837 8-OD 72 108 72 90 28 119 169 166 276 351 Paclitaxel 15 mg/kg q7d4 6-SM 126 424 756 896 1530 2706 6-OD 117 243 257 325 420 699 1064 1632 1536 2166 6-OG 98 240 356 386 673 1200 2380 6-2O 83 280 284 255 410 1008 1309 2040 6-2OD 83 170 380 560 720 1653 1389 2112 6-2OG 66 126 180 347 410 965 2269 10-SM 144 217 180 270 358 823 884 1197 1323 2112 10-OD 58 105 110 198 192 351 437 798 1232 1348 3C23K 10 mg/kg q7d4 + 7-SM 131 126 85 0 0 0 0 0 0 0 Paclitaxel 15 mg/kg q7d4 7-OD 116 105 112 223 160 324 315 390 655 938 7-OG 95 28 0 0 0 0 0 0 0 0 7-2O 88 70 142 150 264 768 875 1033 1400 2112 7-2OD 74 41 112 105 163 357 368 336 399 532 7-2OG 66 41 63 85 63 203 347 281 429 662 10-OG 110 96 104 96 0 0 0 0 0 0 10-2O 61 72 72 27 24 66 63 68 105 200 Day Group 55 58 62 66 69 73 76 80 83 Control 1-SM 1-OD 1-OG 1-2O 1-2OG 1- 10-2OD 2268 10-2OG 2145 3C23K 10 mg/kg q7d4 2-SM 2080 2-OD 2-OG 0 0 0 0 0 0 0 0 0 2-2O 990 1482 1080 1695 1788 1820 2296 2-2OD 1084 1350 1440 1512 1496 1559 1238 1520 1615 2-2OG 600 842 640 666 950 1018 1140 1254 1463 8-SM 1309 1665 2057 8-OD 600 792 1215 1740 2000 Paclitaxel 15 mg/kg q7d4 6-SM 6-OD 6-OG 6-2O 6-2OD 6-2OG 10-SM 10-OD 2132 3C23K 10 mg/kg q7d4 + 7-SM 0 0 0 0 0 0 0 0 0 Paclitaxel 15 mg/kg q7d4 7-OD 1755 1710 2340 7-OG 0 0 0 0 0 0 0 0 0 7-2O 7-2OD 816 1140 1170 2016 7-2OG 924 1109 1620 2081 10-OG 24 53 50 60 96 189 192 347 413 10-2O 324 551 714 1040 1245 1604 1725 2112

TABLE 10 Summary of the raw data for change in mean body weight Days Groups 20 27 35 41 48 55 control Mean 22.83 24.24 25.88 26.07 SD 0.72 0.94 1.34 1.57 3C23K 10 mg/kg q7d4 Mean 24.15 24.78 25.63 26.05 26.06 26.04 SD 2.22 2.21 2.36 2.60 2.32 2.01 Paclitaxel 15 mg/kg Mean 24.66 25.09 27.33 26.80 q7d4 SD 1.17 1.22 2.02 1.55 3C23K 10 mg/kg Mean 23.11 23.76 24.64 24.43 25.29 25.53 q7d4 + Paclitaxel SD 1.48 1.54 1.36 1.33 0.82 1.91 15 mg/kg q7d4

TABLE 11 Summary of the raw data for the mean tumour volumes Days Groups 13 20 24 27 31 35 41 45 48 51 55 Control Mean 93 219 331 538 777 1227 1492 SD 10 48 77 142 205 331 339 3C23K 10 mg/kg q7dx4 Mean 92 111 97 144 153 310 429 577 664 832 SD 16 23 41 81 94 183 215 305 362 482 paclitaxel 15 mg/kg q7dx4 Mean 97 226 313 405 589 1176 1390 SD 11 38 76 86 157 274 290 3C23K 10 mg/kg + paclitaxel Mean 92 72 86 86 84 215 246 263 373 555 549 15 mg/kg q7dx4 SD 9 13 16 29 38 101 114 132 182 272 269

TABLE 12 Summary of the raw data for the median tumour volumes and T/C ratios Days 13 20 24 27 31 35 41 45 48 51 55 Median tumour volume control 93 188 336 515 782 1183 1584 3C23K 10 mg/kg q7dx4 89 107 93 129 162 317 467 577 620 712 paclitaxel 15 mg/kg q7dx4 90 228 270 336 415 986 1309 3C23K 10 mg/kg + paclitaxel 15 mg/kg q7dx4 91 71 94 90 44 134 189 174 252 366 324 T/C ratio control-3C23K 10 mg/kg q7dx4 95 57 28 25 21 27 29 control-paclitaxel 15 mg/kg q7dx4 97 121 80 65 53 83 83 control-3C23K 10 mg/kg q7dx4 + paclitaxel 98 38 28 18 6 11 12 15 mg/kg q7dx4 3C23K 10 mg/kg q7dx4-paclitaxel 15 mg/kg 98 47 35 38 39 32 36 q7dx4 3C23K 10 mg/kg q7dx4-3C23K 10 mg/kg 103 67 101 70 27 42 40 30 41 51 q7dx4 + paclitaxel 15 mg/kg q7dx4 paclitaxel 15 mg/kg q7dx4-3C23K 10 mg/kg + 101 31 35 27 11 14 14 paclitaxel 15 mg/kg q7dx4

TABLE 13 Statistical analysis ANOVA Kruskal - Wallis F- P- P- Day Contrast between groups ratio value Sig. Test value Sig. D13 control-3C23K 10 mg/kg q7d4 0.00 0.95 0.00 0.96 control-paclitaxel 15 mg/kg q7d4 0.07 0.80 0.04 0.83 control-3C23K 10 mg/kg q7d4 + paclitaxel 0.00 0.97 0.00 1.00 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 15 mg/kg 0.11 0.74 0.03 0.87 q7d4 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 0.00 0.98 0.00 0.96 q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-3C23K 10 mg/kg 0.09 0.76 0.07 0.79 q7d4 + paclitaxel 15 mg/kg q7d4 D20 control-3C23K 10 mg/kg q7d4 5.33 0.04 * 4.44 0.04 * control-paclitaxel 15 mg/kg q7d4 0.01 0.91 0.47 0.49 control-3C23K 10 mg/kg q7d4 + paclitaxel 9.71 0.01 * 8.08 0.00 * 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 15 mg/kg 9.54 0.01 * 6.39 0.01 * q7d4 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 5.84 0.03 * 4.44 0.04 * q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-3C23K 10 mg/kg 16.67 0.00 * 9.97 0.00 * q7d4 + paclitaxel 15 mg/kg q7d4 D24 control-3C23K 10 mg/kg q7d4 9.83 0.01 * 4.41 0.04 * control-paclitaxel 15 mg/kg q7d4 0.03 0.86 0.28 0.60 control-3C23K 10 mg/kg q7d4 + paclitaxel 11.11 0.00 * 4.42 0.04 * 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 15 mg/kg 8.53 0.01 * 8.70 0.00 * q7d4 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 0.19 0.67 0.10 0.75 q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-C23K 10 mg/kg 9.71 0.01 * 9.30 0.00 * q7d4 + paclitaxel 15 mg/kg q7d4 D27 control-3C23K 10 mg/kg q7d4 8.21 0.01 * 4.87 0.03 * control-paclitaxel 15 mg/kg q7d4 0.74 0.40 1.10 0.29 control-3C23K 10 mg/kg q7d4 + paclitaxel 11.09 0.00 * 6.90 0.01 * 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 15 mg/kg 8.92 0.01 * 8.66 0.00 * q7d4 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 1.75 0.21 1.11 0.29 q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-3C23K 10 mg/kg 14.22 0.00 * 10.61 0.00 * q7d4 + paclitaxel 15 mg/kg q7d4 D31 control-3C23K 10 mg/kg q7d4 10.00 0.01 * 4.86 0.03 * control-paclitaxel 15 mg/kg q7d4 0.61 0.45 0.89 0.34 control-3C23K 10 mg/kg q7d4 + paclitaxel 12.60 0.00 * 6.67 0.01 * 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 15 mg/kg 8.01 0.01 * 8.66 0.00 * q7d4 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 1.44 0.25 1.75 0.19 q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-3C23K 10 mg/kg 11.13 0.00 * 10.68 0.00 * q7d4 + paclitaxel 15 mg/kg q7d4 D35 control-3C23K 10 mg/kg q7d4 8.26 0.01 * 5.11 0.02 * control-paclitaxel 15 mg/kg q7d4 0.02 0.90 0.10 0.75 control-3C23K 10 mg/kg q7d4 + paclitaxel 9.78 0.01 * 8.09 0.00 * 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 15 mg/kg 10.47 0.01 * 8.65 0.00 * q7d4 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 0.62 0.45 1.23 0.27 q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-3C23K 10 mg/kg 12.39 0.00 * 9.33 0.00 * q7d4 + paclitaxel 15 mg/kg q7d4 D41 control-3C23K 10 mg/kg q7d4 11.82 0.00 * 5.36 0.02 * control-paclitaxel 15 mg/kg q7d4 0.06 0.81 0.20 0.65 control-3C23K 10 mg/kg q7d4 + paclitaxel 15.82 0.00 * 7.14 0.01 * 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 15 mg/kg 12.64 0.00 * 7.71 0.01 * q7d4 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 1.63 0.22 1.75 0.19 q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-3C23K 10 mg/kg 17.31 0.00 * 9.83 0.00 * q7d4 + paclitaxel 15 mg/kg q7d4 D45 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 2.75 0.12 3.05 0.08 q7d4 + paclitaxel 15 mg/kg q7d4 D48 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 1.38 0.26 1.75 0.19 q7d4 + paclitaxel 15 mg/kg q7d4 D51 3C23K 10 mg/kg q7d4-3C23K 10 mg/kg 0.65 0.43 0.81 0.37 q7d4 + paclitaxel 15 mg/kg q7d4

TABLE 14 Summary of the raw data for survival parameter Mouse number Groups Days Observations 1 NaCl 34 2 NaCl 41 3 NaCl 41 4 NaCl 45 5 NaCl 45 6 NaCl 45 7 NaCl 55 8 NaCl 55 1 3C23K 10 mg/kg q7d4 51 2 3C23K 10 mg/kg q7d4 55 3 3C23K 10 mg/kg q7d4 62 4 3C23K 10 mg/kg q7d4 69 5 3C23K 10 mg/kg q7d4 76 6 3C23K 10 mg/kg q7d4 83 End of experiment TV 1615 mm3 7 3C23K 10 mg/kg q7d4 83 End of experiment TV 1463 mm3 8 3C23K 10 mg/kg q7d4 83 End of experiment no tumour 1 Paclitaxel 15 mg/kg q7d4 34 2 Paclitaxel 15 mg/kg q7d4 41 3 Paclitaxel 15 mg/kg q7d4 41 4 Paclitaxel 15 mg/kg q7d4 45 5 Paclitaxel 15 mg/kg q7d4 45 6 Paclitaxel 15 mg/kg q7d4 51 7 Paclitaxel 15 mg/kg q7d4 51 8 Paclitaxel 15 mg/kg q7d4 55 1 3C23K 10 mg/kg q7d4 + Paclitaxel 51 15 mg/kg q7d4 2 3C23K 10 mg/kg q7d4 + Paclitaxel 62 15 mg/kg q7d4 3 3C23K 10 mg/kg q7d4 + Paclitaxel 66 15 mg/kg q7d4 4 3C23K 10 mg/kg q7d4 + Paclitaxel 66 15 mg/kg q7d4 5 3C23K 10 mg/kg q7d4 + Paclitaxel 80 15 mg/kg q7d4 6 3C23K 10 mg/kg q7d4 + Paclitaxel 83 End of experiment 15 mg/kg q7d4 TV 413 mm3 7 3C23K 10 mg/kg q7d4 + Paclitaxel 83 End of experiment 15 mg/kg q7d4 No tumour 8 3C23K 10 mg/kg q7d4 + Paclitaxel 83 End of experiment 15 mg/kg q7d4 No tumour

TABLE 15 Survival parameters Survival parameter Group Mean Median SD Control 45 45 5 3C23K 10 mg/kg q7dx4 70 73 11 Paclitaxel 15 mg/kg q7dx4 45 45 5 3C23K 10 mg/kg + Paclitaxel 72 72 11 15 mg/kg q7dx4 Survival parameter: logrank test chi-squared p-value sign. Control-3C23K 10 mg/kg q7d4 11.15 0.00 * Control-paclitaxel 15 mg/kg q7d4 0.04 0.84 Control-3C23K 10 mg/kg q7d4 + 12.87 0.00 * paclitaxel 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-paclitaxel 12.36 0.00 * 15 mg/kg q7d4 3C23K 10 mg/kg q7d4-3C23K 10 0.17 0.68 mg/kg q7d4 + paclitaxel 15 mg/kg q7d4 paclitaxel 15 mg/kg q7d4-3C23K 10 13.61 0.00 * mg/kg q7d4 + paclitaxel 15 mg/kg q7d4 

The invention claimed is:
 1. A pharmaceutical composition comprising: as active ingredient: an anticancer agent selected from the group consisting of carboplatin, paclitaxel, doxorubicin, pegylated liposomal doxorubicin, and mixtures thereof, and a mutated humanized 12G4 monoclonal antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II) comprising or constituted by: a) a light chain comprising or constituted by: a variable region the amino acid sequence of which is represented by SEQ ID NO: 7 or SEQ ID NO: 8, and a constant region the amino acid sequence of which is represented by SEQ ID NO: 3 b) a heavy chain comprising or constituted by: a variable region the amino acid sequence of which is represented by SEQ ID NO: 9 or SEQ ID NO: 10, and a constant region the amino acid sequence of which is represented by SEQ ID NO: 6; and a pharmaceutically acceptable vehicle.
 2. The pharmaceutical composition according to claim 1, wherein said antibody possesses affinity for AMHR-II characterized by a K_(D)of less than 10⁻⁷ M.
 3. The pharmaceutical composition according to claim 2, wherein said antibody possesses affinity for AMHR-II characterized by a K_(D)of less than 10⁻⁸ M.
 4. The pharmaceutical composition according to claim 2, wherein said antibody possesses affinity for AMHR-II characterized by a K_(D)in the range from 10⁻⁹ M to 10⁻¹¹ M.
 5. The pharmaceutical composition according to claim 1, wherein said antibody is produced by a 3C23K clone.
 6. The pharmaceutical composition according to claim 5, comprising the mutated 12G4 monoclonal antibody produced by the 3C23K clone, and carboplatin.
 7. The pharmaceutical composition according to claim 5, comprising the mutated 12G4 monoclonal antibody produced by the 3C23K clone, and paclitaxel.
 8. The pharmaceutical composition according to claim 1, wherein said antibody is a recombinant antibody produced by animal transgenesis.
 9. The pharmaceutical composition according to claim 1, in a formulation intended for administration by the intravenous or intraperitoneal route.
 10. The pharmaceutical composition according to claim 1, wherein a therapeutically effective quantity of antibody administered to a patient is in a range from about 0.07 mg to about 35000 mg.
 11. The pharmaceutical composition according to claim 10, wherein the therapeutically effective quantity of antibody administered to a patient is in a range from about 0.7 mg to about 7000 mg.
 12. The pharmaceutical composition according to claim 10, wherein the therapeutically effective quantity of antibody administered to a patient is in a range from about 0.7 mg to about 1400 mg.
 13. The pharmaceutical composition according to claim 10, wherein the therapeutically effective quantity of antibody administered to a patient is in a range from about 0.7 mg to about 700 mg.
 14. The pharmaceutical composition according to claim 10, wherein the therapeutically effective quantity of antibody administered to a patient is in a range from about 0.7 mg to about 70 mg.
 15. The pharmaceutical composition according to claim 1, wherein a therapeutically effective quantity of anticancer agent administered to a patient is in a range from about 10 mg to about 700 mg.
 16. The pharmaceutical composition according to claim 15, wherein the therapeutically effective quantity of anticancer agent administered to a patient is in a range from about 20 mg to about 350 mg.
 17. The pharmaceutical composition according to claim 15, wherein the therapeutically effective quantity of anticancer agent administered to a patient is about 110 mg.
 18. The pharmaceutical composition according to claim 1, wherein a dose of antibody administered to a patient is about 70 mg and a dose of anticancer agent administered to the patient is about 110 mg.
 19. The pharmaceutical composition according to claim 1, wherein a therapeutically effective quantity of antibody is from 0.1 mg/kg to 100 mg/kg.
 20. Composition A method for preventing or treating a pathology associated with human anti-Müllerian hormone type II receptor (AMHR-II) comprising administering to a subject in need thereof a composition comprising: an anticancer agent selected from the group consisting of carboplatin, paclitaxel, doxorubicin, pegylated liposomal doxorubicin, and mixtures thereof, and a mutated humanized 12G4 monoclonal antibody binding the human anti-Müllerian hormone type II receptor (AMHR-II)comprising or constituted by: a) a light chain comprising or constituted by: a variable region the amino acid sequence of which is represented by SEQ ID NO: 7 or SEQ ID NO: 8, and a constant region the amino acid sequence of which is represented by SEQ ID NO: 3 b) a heavy chain comprising or constituted by: a variable region the amino acid sequence of which is represented by SEQ ID NO: 9 or SEQ ID NO: 10, and a constant region the amino acid sequence of which is represented by SEQ ID NO:
 6. 21. The method according to claim 20, wherein the pathology associated with the human anti-Müllerian hormone type II receptor (AMHR-II) is cancer.
 22. The method according to claim 21, wherein the cancer is an ovarian cancer.
 23. The method according to claim 21, wherein the cancer is an endometrial cancer.
 24. The method according to claim 21, wherein the cancer is a mixed Müllerian malignant tumor of the uterus. 